TIA NOWACKI, ATC, NBC-HWC — NPI 1982839387 (Licensed & Credentialed Health & Wellness Coach in MERIDIAN, ID)

CMS-1500 Box 24J / 33a • NPI

1982839387

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171400000X

Licensed & Credentialed Health & Wellness Coach

Box 32 Service Location & ZIP+4

5155 S HILLSDALE AVE, MERIDIAN, ID, 83642-7587

✓ 9-Digit EDI 837 ZIP+4 (83642-7587)

Practice Phone & Referral Fax

(208) 706-9710

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1982839387 (TIA NOWACKI, ATC, NBC-HWC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1982839387` (NPI-1 Individual Practitioner)
Provider / Legal Name	TIA NOWACKI, ATC, NBC-HWC
Plain-English Specialty	Licensed & Credentialed Health & Wellness Coach NUCC Code: `171400000X` (Health & Wellness Coach)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	5155 S HILLSDALE AVE, MERIDIAN, ID, 83642-7587
Practice Telephone / Fax	Tel: (208) 706-9710
Administrative Mailing Address	3001 132ND AVE NW, SPICER, MN, 56288-9469
Enumeration & Last Sync	Enumerated: 2009-05-28 \| CMS Record Updated: 2025-06-12

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5155 S HILLSDALE AVE, MERIDIAN, ID, 83642-7587

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Plain-English Taxonomy & CMS Crosswalk (171400000X)

What Does Taxonomy Code 171400000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171400000X translates to:
"Licensed & Credentialed Health & Wellness Coach"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Health & Wellness Coach for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TIA NOWACKI, ATC, NBC-HWC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2255A2300X` — Specialist/Technologist, Athletic Trainer Plain English: Licensed & Credentialed Specialist/Technologist, Athletic Trainer	State: ID \| License: `AT-494` \| Primary: Secondary
`171400000X` — Health & Wellness Coach Plain English: Licensed & Credentialed Health & Wellness Coach	State: ID \| License: `A-3683245` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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TIA NOWACKI, ATC, NBC-HWC (NPI #1982839387)